目的 观察喘可治注射液治疗支气管哮喘急性发作期患者的临床效果.方法 选取2013年6月至2014年10月我院收治的支气管哮喘急性发作期患者91例作为观察对象,按照随机数字表法将其分为对照组(45例)和观察组(46例).对照组患者给予常规治疗,包括止咳化痰、解痉平喘、抗感染、对症治疗等,同时给予异丙托溴铵治疗,观察组患者在对照组患者治疗的基础上加用喘可治注射液治疗,比较两组患者的临床治疗效果及肺功能改善情况.结果 治疗4周,观察组患者的治疗总有效率为97.8％,对照组为75.6％,两组比较差异有统计学意义(P＜0.01);观察组患者的临床疗效显著优于对照组(P＜0.05).治疗前,两组患者FEV1、PEF比较差异无统计学意义(P＞0.05);治疗后,观察组的FEV1、PEF明显改善(P＜0.05),且显著优于对照组(P＜0.05).结论 在常规治疗的基础上,加用喘可治注射液治疗支气管哮喘急性发作期患者临床效果确切,可显著改善患者肺功能,值得推广使用.

Objective To explore the protective effect and safety of activated D supplementation on 3rd stage of diabetic nephropathy in type 2 diabetes.Methods 39 cases with 3rd stage of diabetic nephropathy in type 2 diabetes were enrolled into the study,they were randomly divided into two groups,group DN（19 cases） treated with insulin（Novolin R） and ARB（valsartan 80160 mg/d）,group VD（20 cases）treated with insulin and ARBOalsartan 80160 mg/d),add extra alfacalcidol0.25μg/day for 6 months.The target of blood pressure control was 130/80 mm Hg,the goal of insulin therapy was a fasting blood glucose value of less than 7.0 mmol/L,and a postprandial value of less than 8.0 mmol/L.We chose 20 volunteer with same age,gender ratio from the hospital staff as healthy controls(Group NO.Serum 25-（OH）-D3,HbAlc,iPTH,Calcium（Ca）,phosphate（P）,hsCRP,TNF-α,IL-6 and urine albumin to creatinine ratio（ACR） were measured at baseline.Results Compare with group NC,serum 25-（OH）-D3,levels of 3rd stage of diabetic nephropathy in type 2 diabetes showed a lower level,hs-CRP,TNF-α,IL-6,ACR were high levels at base line.After group VD treated with alfacalcitrol for 6 months,hs-CRP,TNF-α,IL-6,ACR levels in group VD decreased significantly.There was no difference between two group on serum iPTH and P.Conclusions Alfacalcitrol supplementation might delay the development of 3rd stage of diabetic nephropathy in type 2 diabetes through suppressing inflammatioa No effect from alfacalcitrol on the serum iPTH and P levels at 6 months.

目的 观察丹田降脂丸联合氯沙坦对糖尿病肾病患者蛋白尿的影响.方法 将60例2型糖尿病肾病(DN)患者随机分成两组:丹田降脂丸联合氯沙坦组(治疗组)和单独氯沙坦组(对照组),每组30例,给予相应药物治疗6个月,分别观察治疗前后两组24小时尿蛋白定量、总胆固醇(TC)、三酰甘油(TG)和血液流变学的变化.结果 治疗前后治疗组和对照组24小时尿蛋白定量、TC、TG比较差异有统计学意义(P＜0.05)；治疗组治疗前后血浆粘度、全血高切还原粘度、全血低切还原粘度、红细胞聚集指数、红细胞变形指数均明显改善(P＜0.05),治疗组治疗后除全血低切还原粘度(P＞0.05)之外,其他各项指标均优于对照组(P＜0.05).结论 丹田降脂丸联合氯沙坦治疗DN能减少尿蛋白,疗效优于单用氯沙坦,且能有效改善血脂代谢异常和血液流变学等作用.

Objective To compare the clinic efficacy and safety of renal osteodystrophy between hemodiafiltration (HDF)com-bined low dose calcitriol and high flux hemodialysis combined high dose Calcitriol .Methods 25 patients ,who were in accordance with the inclusion criteria ,were randomly divided into HDF combined low dose Calcitriol group (group HDF) (n=13) and high flux hemodialysis combined high dose Calcitriol (group VitD)(n=12) .Patients in group HDF took Calcitriol for 0 .5μg after every dialysis session ,while those in group VitD took it for 1 .0 μg after dialysis at first ,then the dose would be adjusted every 4 weeks according to the level of blood Calcium .The intervention continued for 16 weeks in total .Then detecting the levels of intact parathy-roid hormone (iPTH) ,bone alkaline phosphatase (BAP) ,serum calcium (Ca) ,serum phosphorus (P) ,and calculating Ca × P sedi-mentation and clinical symptom score .Results he level of Ca in group HDF and group VitD increased significantly after interven-tion (P= 0 .000) .No difference was no statistically significant between the two groups (P= 0 .141) .The P ,iPTH ,BAP of two groups were significantly decreased (P<0 .05) .P in group HDF decreased more significantly(P=0 .003) .iPTH and BAP in group VitD decreased more significantly (P=0 .034 ,0 .046);Ca × P in group HDF decreased significantly (P=0 .031) ,but increased obvi-ously in group VitD(P=0 .037) ,which was much higher than group HDF(P=0 .001) .Clinical symptom in the two groups im-proved significantly after intervention(P<0 .05) ,There were no significant difference between the two groups(P=0 .632) .Conclu-sion The clinic efficacy of HDF combined low dose calcitriol is same as that of high flux hemodialysis combined high dose calcitri-ol .It could also reduce calcitriol side-effect ,which is an effective theraphy for high turnover osteodystrophy .

目的探讨高血压肾脏损害患者的发病机制及治疗方法。方法对我院1997年1月—2012年1月所收治的100例高血压出现肾脏损害的患者进行回顾性分析。结果好转47例(包括肾功能改善、水肿消退、尿蛋白减少),41例需进行维持性血液透析治疗,5例死于急性左心衰合并肺部感染,4例死于脑出血,3例放弃治疗后死亡。结论早期诊断高血压,并早期治疗控制高血压肾损害,可以改善患者的症状,延长生存时间,提高患者的生活质量。